Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Mission Grove Medical Corporation

Organization Pulmonary Disease Physician · NPI 1205224417

Mission Grove Medical Corporation provides Pulmonary Disease Physician services in Riverside, California. Licensed in California. Registered with an NPI since 2014.

Licensed in
CA
In the registry since
2014
Specialties on file
3

Practice location Address checks out

191 E Alessandro Blvd # 9A
Riverside, CA 92508-5095
Phone: (951) 780-3300
Fax: (951) 780-3303
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pulmonary Disease Physician (primary) Taxonomy 207RP1001X
Urgent Care Clinic/Center Taxonomy 261QU0200X · Licence A39116 (CA)
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1205224417
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Sibonisiwe Johnson — Ao · (951) 780-3300
Other names Urgent Care Clinic
NPI enumeratedDecember 23, 2014
Last updated in NPPESSeptember 8, 2026
Certification dateSeptember 8, 2026
Mailing address191 E Alessandro Blvd # 9a, Riverside, CA 92508-5095

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